DENTISTRY
Figure 3A. A persistent primary right mandibular canine
producing mesioversion of the secondary mandibular canine.
Figure 5A. Left mandibular persistent primary tooth extraction
indicated.
2. Use a No. 2 molt periosteal elevator to expose
the primary canine root (Figure 4B)
Figure 3B. Mesioversion of the left mandibular canine.
Treatment
Now that we’ve defined the problem, let’s fix it! A
persistent primary tooth should be extracted as soon
as the permanent tooth is observed to erupt in the
same alveolus. The goal is to remove the entire primary
tooth without fracture of the root. Examination of
intraoral radiographs before extraction is important to
get an appreciation of the subgingival anatomy of the
tooth to be extracted.
Figure 4B. Flap exposure of the primary canine tooth.
3. Insert and gently torque a wing-tipped elevator
to create mobility of the tooth before delivery
(Figures 4C and 5B).
Here are the extraction steps after examining
intraoral radiographs:
1. Make a diagonal incision over the caudal primary
canine root (Figures 4A and 5A).
Figure 4C. Wing-tipped elevator used to loosen the primary
canine tooth.
Figure 4A. Left maxillary persistent primary canine tooth.
Gingical incision used to expose the persistent primary tooth.
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Issue 02 | MAY 2019
| 32 04 | AUGUST 2017 32
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